Use of alendronate and risk of incident atrial fibrillation in women
Use of alendronate and risk of incident atrial fibrillation in women
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DOI：
10.1001/archinte.168.8.826
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发表时间：
2008-04-28
影响因子：
--
通讯作者：
Psaty, Bruce M.
中科院分区：
文献类型：
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作者：
Heckbert, Susan R.;Li, Guo;Psaty, Bruce M.
背景：最近发表的一项针对绝经后骨质疏松症妇女的试验报告称，接受唑来膦酸治疗的患者比接受安慰剂治疗的患者发生严重房颤(AF)的风险更高。这种不良反应是意想不到的，以前也没有被认识到。方法：我们在临床实践中研究了阿伦磷酸钠的使用与女性发生房颤的风险之间的关系。这项以人群为基础的病例对照研究是在华盛顿州的综合医疗保健提供系统Group Health进行的。我们确定了2001年10月1日至2004年12月31日期间719名确诊发生房颤的女性和966名没有房颤的女性对照受试者，这些受试者是从团体健康登记中随机选择的，频率与年龄、有无治疗高血压和历年匹配。结果：房颤病例患者比对照组更多地使用过阿仑磷酸钠(6.5%[n=47]比4.1%[n=40]；P=.03)。与从未使用任何双磷酸盐相比，在对匹配变量、骨质疏松症的诊断和心血管疾病病史进行调整后，曾经使用阿伦磷酸钠的患者发生房颤的风险更高(优势比为1.86；95%可信区间为1.09-3.15)。基于人群归因分数，我们估计该人群中3%的房颤事件可能是由阿伦磷酸钠的使用来解释的。结论：在临床实践中，曾经使用阿伦磷酸钠与房颤事件风险增加相关。
Background: A recent publication from the HORIZON (Health Outcomes and Reduced Incidence With Zoledronic Acid Once dearly) trial in women with postmenopausal osteoporosis reported a higher risk of serious atrial fibrillation (AF) in zoledronic acid recipients than in placebo recipients. This adverse effect was unexpected and had not been recognized previously.Methods: We studied alendronate sodium ever use in relation to the risk of incident AF in women in a clinical practice setting. This population-based case-control study was conducted at Group Health, an integrated health care delivery system in Washington State. We identified 719 women with confirmed incident AF between October 1, 2001, and December 31, 2004, and 966 female control subjects without AF, selected at random from the Group Health enrollment and frequency matched on age, presence or absence of treated hypertension, and calendar year.Results: More AF case patients than controls had ever used alendronate (6.5% [n=47] vs 4.1% [n=40]; P=.03). Compared with never use of any bisphosphonate, ever use of alendronate was associated with a higher risk of incident AF (odds ratio, 1.86; 95% confidence interval, 1.09-3.15) after adjustment for the matching variables, a diagnosis of osteoporosis, and a history of cardiovascular disease. Based on the population-attributable fraction, we estimated that 3% of incident AF in this population might be explained by alendronate use.Conclusion: Ever use of alendronate was associated with an increased risk of incident AF in clinical practice.